Prolactinoma differential diagnosis: Difference between revisions

Jump to navigation Jump to search
m (Bot: Removing from Primary care)
 
(45 intermediate revisions by 9 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Prolactinoma}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Prolactinoma]]
{{CMG}}; {{AE}} {{Anmol}}


==Overview==
==Overview==
Prolactinoma must be differentiated from other diseases that cause hyperprolactinemia including hypothyroidism and side effects of medications including antipsychotics and antidepressants.
[[Prolactinoma]] must be differentiated from other causes of [[hyperprolactinemia]] that may present as [[galactorrhea]], [[amenorrhea]], (in females) and [[infertility]] (in both males and females). Causes of [[hyperprolactinemia]] can be categorized as [[physiological]], [[pathological]], and [[medication-induced]].


==Differential Diagnosis==
==Differential Diagnosis==
Prolactinoma must be differentiated from other diseases that cause hyperprolactinemia including:
[[Prolactinoma]] must be differentiated from other causes of [[hyperprolactinemia]] that may present as [[galactorrhea]], [[amenorrhea]], (in females) and [[infertility]] (in both males and females) including:
*[[Prescription drugs]]. Prolactin secretion in the pituitary is normally suppressed by the brain chemical dopamineDrugs that block the effects of dopamine at the pituitary or deplete [[dopamine]] stores in the brain may cause the [[pituitary]] to secrete [[prolactin]].  These drugs include older antipsychotic medications such as trifluoperazine (Stelazine) and [[haloperidol]] (Haldol); the newer antipsychotic drugs risperidone (Risperdal) and molindone (Moban); metoclopramide (Reglan), used to treat gastroesophageal reflux and the nausea caused by certain cancer drugs; and less often, verapamil, alpha-methyldopa (Aldochlor, Aldoril), and reserpine (Serpalan, Serpasil), used to control high blood pressureSome antidepressants may cause hyperprolactinemia, but further research is needed<ref>http://www.niddk.nih.gov/health-information/health-topics/endocrine/prolactinoma/Pages/fact-sheet.aspx</ref>.
*'''Physiological:'''
*Other [[pituitary]] tumors. Other tumors arising in or near the pituitary may block the flow of dopamine from the brain to the prolactin-secreting cells.  Such tumors include:
**Normal [[pregnancy]]<ref name="pmid910825">{{cite journal| author=Rigg LA, Lein A, Yen SS| title=Pattern of increase in circulating prolactin levels during human gestation. | journal=Am J Obstet Gynecol | year= 1977 | volume= 129 | issue= 4 | pages= 454-6 | pmid=910825 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=910825  }} </ref>
 
*'''Pathological:'''
**Somatotroph adenoma: It results in [[acromegaly]], a condition caused by excessive growth hormone
**[[Pituitary tumors]] (other than [[prolactinoma]]):<ref name="pmid15316045">{{cite journal| author=Levy A| title=Pituitary disease: presentation, diagnosis, and management. | journal=J Neurol Neurosurg Psychiatry | year= 2004 | volume= 75 Suppl 3 | issue=  | pages= iii47-52 | pmid=15316045 | doi=10.1136/jnnp.2004.045740 | pmc=1765669 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15316045 }} </ref>
 
***[[Somatotroph adenoma]]: [[Acromegaly]]
**Corticotroph adenoma: It results in [[Cushing's syndrome]], caused by excessive [[cortisol]].
***[[ACTH-secreting tumor|Corticotroph adenoma]]: [[Cushing's syndrome]]
 
**[[Suprasellar tumors]] ([[tumors]] present in the region of the [[pituitary stalk]])
Other pituitary tumors that do not result in excess hormone production may also block the flow of [[dopamine]].
**[[Hypothyroidism]]<ref name="pmid4199418">{{cite journal| author=Snyder PJ, Jacobs LS, Utiger RD, Daughaday WH| title=Thyroid hormone inhibition of the prolactin response to thyrotropin-releasing hormone. | journal=J Clin Invest | year= 1973 | volume= 52 | issue= 9 | pages= 2324-9 | pmid=4199418 | doi=10.1172/JCI107421 | pmc=333037 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4199418  }} </ref>
*[[Hypothyroidism]]. Increased prolactin levels are often seen in people with hypothyroidism, a condition in which the [[thyroid]] does not produce enough thyroid hormone. Physicians  routinely test people with hyperprolactinemia for [[hypothyroidism]].
**[[Chronic renal failure]]<ref name="pmid7372775">{{cite journal| author=Sievertsen GD, Lim VS, Nakawatase C, Frohman LA| title=Metabolic clearance and secretion rates of human prolactin in normal subjects and in patients with chronic renal failure. | journal=J Clin Endocrinol Metab | year= 1980 | volume= 50 | issue= 5 | pages= 846-52 | pmid=7372775 | doi=10.1210/jcem-50-5-846 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7372775  }} </ref>
*Chest involvement. Nipple stimulation also can cause a modest increase in the amount of prolactin in the blood.  Similarly, chest wall injury or shingles involving the chest wall may also cause hyperprolactinemia.
**[[Hepato-biliary diseases|Liver disease]]<ref name="pmid26958514">{{cite journal| author=Jha SK, Kannan S| title=Serum prolactin in patients with liver disease in comparison with healthy adults: A preliminary cross-sectional study. | journal=Int J Appl Basic Med Res | year= 2016 | volume= 6 | issue= 1 | pages= 8-10 | pmid=26958514 | doi=10.4103/2229-516X.173984 | pmc=4765284 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26958514 }} </ref>
***[[Cirrhosis]] (with or without [[encephalopathy]])
***[[Viral hepatitis]] (with [[encephalopathy]])
**[[Seizure|Seizure disorder]]<ref name="Ben-Menachem2006">{{cite journal|last1=Ben-Menachem|first1=Elinor|title=Is Prolactin a Clinically Useful Measure of Epilepsy?|journal=Epilepsy Currents|volume=6|issue=3|year=2006|pages=78–79|issn=1535-7597|doi=10.1111/j.1535-7511.2006.00104.x}}</ref><ref name="pmid737437">{{cite journal| author=Trimble MR| title=Serum prolactin in epilepsy and hysteria. | journal=Br Med J | year= 1978 | volume= 2 | issue= 6153 | pages= 1682 | pmid=737437 | doi= | pmc=1608938 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=737437  }} </ref>
*'''Medication-induced:'''
**[[Antipsychotic]] medications:<ref name="pmid11048906">{{cite journal| author=David SR, Taylor CC, Kinon BJ, Breier A| title=The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia. | journal=Clin Ther | year= 2000 | volume= 22 | issue= 9 | pages= 1085-96 | pmid=11048906 | doi=10.1016/S0149-2918(00)80086-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11048906  }} </ref>
***[[Haloperidol]]
***[[Risperidone]]
**[[Antiemetic]] medications:
***[[Metoclopramide]]<ref name="pmid777023">{{cite journal| author=McCallum RW, Sowers JR, Hershman JM, Sturdevant RA| title=Metoclopramide stimulates prolactin secretion in man. | journal=J Clin Endocrinol Metab | year= 1976 | volume= 42 | issue= 6 | pages= 1148-52 | pmid=777023 | doi=10.1210/jcem-42-6-1148 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=777023  }} </ref>
***[[Domperidone]]<ref name="pmid7037817">{{cite journal| author=Sowers JR, Sharp B, McCallum RW| title=Effect of domperidone, an extracerebral inhibitor of dopamine receptors, on thyrotropin, prolactin, renin, aldosterone, and 18-hydroxycorticosterone secretion in man. | journal=J Clin Endocrinol Metab | year= 1982 | volume= 54 | issue= 4 | pages= 869-71 | pmid=7037817 | doi=10.1210/jcem-54-4-869 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7037817 }} </ref>
**[[Antihypertensive]] medications:
***[[Methyldopa]]<ref name="pmid1268617">{{cite journal| author=Steiner J, Cassar J, Mashiter K, Dawes I, Fraser TR, Breckenridge A| title=Effects of methyldopa on prolactin and growth hormone. | journal=Br Med J | year= 1976 | volume= 1 | issue= 6019 | pages= 1186-8 | pmid=1268617 | doi= | pmc=1639736 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1268617  }} </ref>
***[[Verapamil]]<ref name="pmid6682619">{{cite journal| author=Fearrington EL, Rand CH, Rose JD| title=Hyperprolactinemia-galactorrhea induced by verapamil. | journal=Am J Cardiol | year= 1983 | volume= 51 | issue= 8 | pages= 1466-7 | pmid=6682619 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6682619  }} </ref>
{|
! style="background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Disease}}
! style="background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Clinical Findings}}
! style="background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Laboratory Findings}}
! style="background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Management}}
|-
| style="background: #DCDCDC; text-align: center;" |[[Somatotroph adenoma]]:
[[Acromegaly]]
| style="background: #F5F5F5;" |Clinical features of [[acromegaly]] are due to high level of [[Growth hormone|human growth hormone]] ([[Growth hormone|hGH]]):
* [[Soft tissue]] [[swelling]] of the hands and feet
* Brow and lower jaw protrusion
* Enlarged hands
* Enlarged feet
* [[Arthritis]] and [[carpal tunnel syndrome]]
* Increase in teeth spacing
* [[Macroglossia]] (enlarged tongue)
* [[Heart failure]]
* [[Kidney failure]]
* Compression of the [[optic chiasma]] leading to loss of [[vision]] in the outer [[visual fields]] (typically [[bitemporal hemianopia]])
* [[Headache]]
* [[Diabetes mellitus]]
* [[Hypertension]]
* [[Cardiomegaly]]
| style="background: #F5F5F5;" |
* Elevated [[insulin-like growth factor-1]] ([[Insulin-like growth factor-I|IGF-1]]) levels
* Elevated [[growth hormone]] levels
| style="background: #F5F5F5;" |
* Medical management:
** [[Octreotide]]
** [[Bromocriptine]]
* Surgical management:
** Endonasal transsphenoidal surgery
* [[Radiation therapy]]
|-
| style="background: #DCDCDC; text-align: center;" |[[ACTH-secreting tumor|Corticotroph adenoma]]:
[[Cushing's syndrome]]
| style="background: #F5F5F5;" |Clinical features of [[Cushing's syndrome]] are due to increased levels of [[cortisol]]:
* Rapid [[Obesity|weight gain]], particularly of the [[trunk]] and face with sparing of the [[limbs]] ([[central obesity]])
* Proximal [[muscle weakness]]
* A round face often referred to as a "[[moon face]]"
* Excess [[sweating]]
* [[Headache]]
* The excess [[cortisol]] may also affect other endocrine systems and cause, for example:
** [[Insomnia]]
** Reduced [[libido]]
** [[Impotence]]
** [[Amenorrhea]]
** [[Infertility]]
* Patients frequently suffer various [[psychological]] disturbances, ranging from [[Euphoria (emotion)|euphoria]] to [[psychosis]]. [[Clinical depression|Depression]] and [[anxiety]] are also common.
| style="background: #F5F5F5;" |
* [[Dexamethasone suppression test]]
* 24 hour urinary measurement of [[cortisol]]
| style="background: #F5F5F5;" |
* Medical management:
** [[Pasireotide]]
** [[Cabergoline]]
** [[Ketoconazole]]
** [[Metyrapone]]
** [[Mitotane]]
** [[Mifepristone]]
* Surgical management:
** Transsphenoidal [[Pituitary gland|pituitary]] resection
|-
| style="background: #DCDCDC; text-align: center;" |[[Hypothyroidism]]
| style="background: #F5F5F5;" |Clinical features of [[hypothyroidism]] are due to deficiency of [[thyroxine]]:
* [[Fatigue]]
* Cold intolerance
* Decreased [[sweating]]
* [[Hypothermia]]
* Coarse [[skin]]
* [[Weight gain]]
* [[Hoarseness]]
* [[Goiter]]
* Fullness in the throat and neck
* [[Depression]]
* [[Emotional lability]]
* [[Attention deficit]]
| style="background: #F5F5F5;" |
* Elevated [[Thyroid-stimulating hormone|TSH]]
* Low [[Thyroxine|T4]]
* Low [[Triiodothyronine|T3]]
* Elevated anti-thyroid [[antibodies]](anti-TPO)
| style="background: #F5F5F5;" |
*[[Levothyroxine]]
|-
| style="background: #DCDCDC; text-align: center;" |[[Chronic renal failure]]
| style="background: #F5F5F5;" |There are no [[pathognomonic]] symptoms associated with [[chronic renal failure]]. Common non-specific symptoms of [[chronic renal failure]] include:
* [[Malaise]]
* [[Nausea]]
* Unintentional [[weight loss]]
* [[Pruritus]]
* [[Lower extremity edema]]
* [[Sleep disorders]]
| style="background: #F5F5F5;" |[[Urinalysis]]:
* [[Albuminuria]]
* [[Hematuria]]
* [[Pyuria]]
* [[Red blood cell|Red cell]] or [[White blood cells|white cell]] [[casts]] and crystals
[[Fluid and electrolytes|Fluid and electrolyte]] disturbances:
* [[Hyponatremia]]
* [[Hyperkalemia]]
* [[Hyperphosphatemia]]
* [[Hyperchloremia]]
* [[Metabolic acidosis]]
* [[Hypocalcemia]]
[[Endocrine system|Endocrine]] and [[metabolic]] disturbances:
* [[Hyperuricemia]]
* [[Hypertriglyceridemia]]
* Decreased [[HDL]] levels
* [[Vitamin D deficiency]]
* Increased [[Parathyroid hormone]] levels
[[Hematologic]] abnormalities:
* [[Normocytic normochromic anemia]]
* [[Lymphocytopenia]]
* [[Leukopenia]]
* [[Thrombocytopenia]]
| style="background: #F5F5F5;" |
* Medical management:
** [[Blood pressure medication|Blood pressure management]]
** Control of [[Blood sugar|blood glucose]]
** [[Protein]] restriction
** Management of [[anemia]]
** Management of [[electrolyte disturbance]]
** [[Dialysis]]
* Surgical management
** [[Kidney transplant]]
|-
| style="background: #DCDCDC; text-align: center;" |[[Cirrhosis|Liver disease: Cirrhosis]]
| style="background: #F5F5F5;" |The clinical features of liver [[cirrhosis]] are very nonspecific. These include:
* [[Right upper quadrant (abdomen)|Right upper quadrant]] [[abdominal pain]]
* [[Fever]]
* [[Fatigue]] and [[weakness]]
* [[Loss of appetite]]
* [[Diarrhea]]
* [[Nausea]] and [[vomiting]]
* [[Weight loss]]
* [[Abdominal pain]] and [[bloating]] when fluid accumulates in the [[abdomen]]
* [[Itching]]
* [[Menstrual cycle|Menstrual]] irregularities
| style="background: #F5F5F5;" |
*Elevated [[aminotransferases]] ([[Aspartate transaminase|AST]] & [[Alanine transaminase|ALT]])
*Elevated [[alkaline phosphatase]] ([[Alkaline phosphatase|ALP]])
*Elevated [[gamma-glutamyl transpeptidase]]
*Elevated [[bilirubin]]
*Low [[albumin]]
*Elevated [[prothrombin time]]
*Elevated [[globulin]]
*[[Hyponatremia]]
*[[Anemia]]
*[[Leukopenia]] and [[neutropenia]]
*[[Thrombocytopenia]]
| style="background: #F5F5F5;" |
* Medical management:
** Treatment is usually directed towards the treatment of complications like [[ascites]], [[esophageal varices]], [[hepatic encephalopathy]], [[hepatorenal syndrome]], and [[spontaneous bacterial peritonitis]].
*** Some chronic constitutional [[symptoms]] that should be treated include:
**** [[Pruritis]]: [[Cholestyramine]] is the drug of choice
**** [[Hypogonadism]]: Topical [[testosterone]] preparations
**** [[Osteoporosis]]: [[Calcium]] and [[vitamin D]]
**** Pain management: [[Non-steroidal anti-inflammatory drug|NSAIDS]], [[celecoxib]], [[opioids]]
**** Nutrition: Adequate [[Calories|caloric]] and [[protein]] intake, and [[multivitamin]] supplementation
* Surgical management: [[Liver transplantation]]
|-
| style="background: #DCDCDC; text-align: center;" |[[Seizure|Seizure disorder]]
| style="background: #F5F5F5;" |The clinical features of [[seizure disorder]] may include:
* Change in [[alertness]], orientation and time perception
* Mood changes, such as unexplainable fear, panic, joy, or laughter
* Changes in sensation of the [[skin]], usually spreading over the [[arm]], [[Leg (anatomy)|leg]], or [[trunk]]
* [[Vision]] changes, including seeing flashing lights
* Rarely, [[Hallucination|hallucinations]] (seeing things that aren't there)
* Falling, loss of [[muscle]] control, occurs very suddenly
* [[Muscle twitching]] that may spread up or down an [[arm]] or [[leg]]
* [[Muscle]] tension or tightening that causes twisting of the body, [[head]], [[Arm|arms]], or [[legs]]
* Shaking of the entire body
* Tasting a bitter or metallic flavor
| style="background: #F5F5F5;" |
*[[Electroencephalogram]]
| style="background: #F5F5F5;" |
* Medical management:
** [[Antiepileptics|Antiepileptic]] medications
|-
| style="background: #DCDCDC; text-align: center;" |[[Medication-induced]]
| style="background: #F5F5F5;" |Clinical features of [[hyperprolactinemia]] after a specific period of regular medication ingestion
| style="background: #F5F5F5;" |
*Discontinuation of the medication for 3 days and remeasurement of [[prolactin]] levels<ref name="pmid21296991">{{cite journal| author=Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA et al.| title=Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. | journal=J Clin Endocrinol Metab | year= 2011 | volume= 96 | issue= 2 | pages= 273-88 | pmid=21296991 | doi=10.1210/jc.2010-1692 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21296991  }}</ref>
| style="background: #F5F5F5;" |
*Change to alternate medication
|}


== References ==
== References ==
{{Reflist|2}}
{{Reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}


[[Category:Disease]]
[[Category:Disease]]
[[Category:Neuroendocrinology]]
[[Category:Neuroendocrinology]]
[[Category:Mature chapter]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Endocrinology]]
[[Category:Up-To-Date]]
[[Category:Neurology]]
[[Category:Neurosurgery]]

Latest revision as of 23:49, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]

Overview

Prolactinoma must be differentiated from other causes of hyperprolactinemia that may present as galactorrhea, amenorrhea, (in females) and infertility (in both males and females). Causes of hyperprolactinemia can be categorized as physiological, pathological, and medication-induced.

Differential Diagnosis

Prolactinoma must be differentiated from other causes of hyperprolactinemia that may present as galactorrhea, amenorrhea, (in females) and infertility (in both males and females) including:

Disease Clinical Findings Laboratory Findings Management
Somatotroph adenoma:

Acromegaly

Clinical features of acromegaly are due to high level of human growth hormone (hGH):
Corticotroph adenoma:

Cushing's syndrome

Clinical features of Cushing's syndrome are due to increased levels of cortisol:
Hypothyroidism Clinical features of hypothyroidism are due to deficiency of thyroxine:
Chronic renal failure There are no pathognomonic symptoms associated with chronic renal failure. Common non-specific symptoms of chronic renal failure include: Urinalysis:

Fluid and electrolyte disturbances:

Endocrine and metabolic disturbances:

Hematologic abnormalities:

Liver disease: Cirrhosis The clinical features of liver cirrhosis are very nonspecific. These include:
Seizure disorder The clinical features of seizure disorder may include:
  • Change in alertness, orientation and time perception
  • Mood changes, such as unexplainable fear, panic, joy, or laughter
  • Changes in sensation of the skin, usually spreading over the arm, leg, or trunk
  • Vision changes, including seeing flashing lights
  • Rarely, hallucinations (seeing things that aren't there)
  • Falling, loss of muscle control, occurs very suddenly
  • Muscle twitching that may spread up or down an arm or leg
  • Muscle tension or tightening that causes twisting of the body, head, arms, or legs
  • Shaking of the entire body
  • Tasting a bitter or metallic flavor
Medication-induced Clinical features of hyperprolactinemia after a specific period of regular medication ingestion
  • Discontinuation of the medication for 3 days and remeasurement of prolactin levels[13]
  • Change to alternate medication

References

  1. Rigg LA, Lein A, Yen SS (1977). "Pattern of increase in circulating prolactin levels during human gestation". Am J Obstet Gynecol. 129 (4): 454–6. PMID 910825.
  2. Levy A (2004). "Pituitary disease: presentation, diagnosis, and management". J Neurol Neurosurg Psychiatry. 75 Suppl 3: iii47–52. doi:10.1136/jnnp.2004.045740. PMC 1765669. PMID 15316045.
  3. Snyder PJ, Jacobs LS, Utiger RD, Daughaday WH (1973). "Thyroid hormone inhibition of the prolactin response to thyrotropin-releasing hormone". J Clin Invest. 52 (9): 2324–9. doi:10.1172/JCI107421. PMC 333037. PMID 4199418.
  4. Sievertsen GD, Lim VS, Nakawatase C, Frohman LA (1980). "Metabolic clearance and secretion rates of human prolactin in normal subjects and in patients with chronic renal failure". J Clin Endocrinol Metab. 50 (5): 846–52. doi:10.1210/jcem-50-5-846. PMID 7372775.
  5. Jha SK, Kannan S (2016). "Serum prolactin in patients with liver disease in comparison with healthy adults: A preliminary cross-sectional study". Int J Appl Basic Med Res. 6 (1): 8–10. doi:10.4103/2229-516X.173984. PMC 4765284. PMID 26958514.
  6. Ben-Menachem, Elinor (2006). "Is Prolactin a Clinically Useful Measure of Epilepsy?". Epilepsy Currents. 6 (3): 78–79. doi:10.1111/j.1535-7511.2006.00104.x. ISSN 1535-7597.
  7. Trimble MR (1978). "Serum prolactin in epilepsy and hysteria". Br Med J. 2 (6153): 1682. PMC 1608938. PMID 737437.
  8. David SR, Taylor CC, Kinon BJ, Breier A (2000). "The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia". Clin Ther. 22 (9): 1085–96. doi:10.1016/S0149-2918(00)80086-7. PMID 11048906.
  9. McCallum RW, Sowers JR, Hershman JM, Sturdevant RA (1976). "Metoclopramide stimulates prolactin secretion in man". J Clin Endocrinol Metab. 42 (6): 1148–52. doi:10.1210/jcem-42-6-1148. PMID 777023.
  10. Sowers JR, Sharp B, McCallum RW (1982). "Effect of domperidone, an extracerebral inhibitor of dopamine receptors, on thyrotropin, prolactin, renin, aldosterone, and 18-hydroxycorticosterone secretion in man". J Clin Endocrinol Metab. 54 (4): 869–71. doi:10.1210/jcem-54-4-869. PMID 7037817.
  11. Steiner J, Cassar J, Mashiter K, Dawes I, Fraser TR, Breckenridge A (1976). "Effects of methyldopa on prolactin and growth hormone". Br Med J. 1 (6019): 1186–8. PMC 1639736. PMID 1268617.
  12. Fearrington EL, Rand CH, Rose JD (1983). "Hyperprolactinemia-galactorrhea induced by verapamil". Am J Cardiol. 51 (8): 1466–7. PMID 6682619.
  13. Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA; et al. (2011). "Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline". J Clin Endocrinol Metab. 96 (2): 273–88. doi:10.1210/jc.2010-1692. PMID 21296991.

Template:WikiDoc Sources